Nonpharmacological Pain Management

NONPHARMALOGICAL PAIN MANAGEMENT

• Best approach is combination therapy (especially for moderate to severe pain)
• Techniques:
  • Distracton
  • Relaxation
  • Guided Imagery
  • Cutaneous stimulation
• Goal: To provide coping strategies that may
  • help reduce pain perception
  • make pain more tolerable
  • decrease anxiety
  • enhance effectiveness of analgesics or reduce the dosage required
  • provide sense of control
  • enhance comfort
  • promote sleep and rest
• Strategies are safe, noninvasive, inexpensive, and most are independent nursing functions
• When teaching children about the various strategies:
  • offer a selection and let the child choose the most appealing one
  • involve the parents
    • they are familiar with the child's coping skills
    • and it provides an opportunity for you to teach parents about other coping mechanisms
• WHEN
  • Children should learn to use specific strategies before the pain occurs or before it becomes more severe
  • Children should also be taught to use coping skills after painful procedures (this allows the child to recover, feel mastery, and cope more effectively)

Example of nonpharmacological techniques:
o Positioning, swaddling
o Breathing, relaxation techniques
o Splinting
o Calm environment (low noise, reduced lighting)
o Heat or cold application
o Distraction (video games, cartoons, videos)
o Being held or rocked
o Sucrose pacifiers for infants during procedures
o Biofeedback
o Guided imagery
o Positive self talk
o Behavioral contracting
o Therapeutic exercise
o Hypnosis
o Massage
o Acupuncture
o Accupressure
o Transcutaneous electrical nerve stimulation (TENS)
o Kangaroo care (skin to skin holding of infants dressed only in diapers against their mother or father’s chest)